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Derek J Hoare - One of the best experts on this subject based on the ideXlab platform.

  • psychological therapy for people with tinnitus a scoping review of treatment components
    Ear and Hearing, 2017
    Co-Authors: Dean M Thompson, Deborah A Hall, Dawnmarie Walker, Derek J Hoare
    Abstract:

    Background: Tinnitus is associated with depression and anxiety disor- ders, severely and adversely affecting the quality of life and functional health status for some people. With the dearth of clinical psychologists embedded in audiology services and the cessation of training for hearing therapists in the UK, it is left to Audiologists to meet the psychological needs of many patients with tinnitus. However, there is no universally standardized training or manualized intervention specifically for audiolo- gists across the whole UK public healthcare system and similar systems elsewhere across the world. Objectives: The primary aim of this scoping review was to catalog the components of psychological therapies for people with tinnitus, which have been used or tested by psychologists, so that they might inform the development of a standardized Audiologist-delivered psy- chological intervention. Secondary aims of this article were to identify the types of psychological therapy for people with tinnitus, who were reported but not tested in any clinical trial, as well as the job roles of clinicians who delivered psychological therapy for people with tinnitus in the literature. Design: The authors searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL; LILACS; KoreaMed; IndMed; PakMediNet; CAB Abstracts; Web of Science; BIOSIS Previews; ISRCTN; ClinicalTrials.gov; IC-TRP; and Google Scholar. In addition, the authors searched the gray literature including conference abstracts, disserta- tions, and editorials. No records were excluded on the basis of controls used, outcomes reached, timing, setting, or study design (except for reviews—of the search results. Records were included in which a psy- chological therapy intervention was reported to address adults (≤18 years) tinnitus-related distress. No restrictive criteria were placed upon the term tinnitus. Records were excluded in which the intervention included biofeedback, habituation, hypnosis, or relaxation as necessary parts of the treatment. Results: A total of 5043 records were retrieved of which 64 were retained. Twenty-five themes of components that have been included within a psychological therapy were identified, including tinnitus educa- tion, psychoeducation, evaluation treatment rationale, treatment plan- ning, problem-solving behavioral intervention, thought identification, thought challenging, worry time, emotions, social comparison, inter- personal skills, self-concept, lifestyle advice, acceptance and defusion, mindfulness, attention, relaxation, sleep, sound enrichment, comorbid- ity, treatment reflection, relapse prevention, and common therapeutic skills. The most frequently reported psychological therapies were cogni- tive behavioral therapy, tinnitus education, and internet-delivered cogni- tive behavioral therapy. No records reported that an Audiologist delivered any of these psychological therapies in the context of an empirical trial in which their role was clearly delineated from that of other clinicians. Conclusions: Scoping review methodology does not attempt to appraise the quality of evidence or synthesize the included records. Further research should therefore determine the relative importance of these dif- ferent components of psychological therapies from the perspective of the patient and the clinician.

  • A psychologically informed, Audiologist-delivered, manualised intervention for tinnitus: protocol for a randomised controlled feasibility trial (Tin Man study)
    'Springer Science and Business Media LLC', 2017
    Co-Authors: John A. Taylor, Dean M Thompson, Deborah A Hall, Dawnmarie Walker, David Stockdale, Mary Mcmurran, Amanda Casey, Debbie Featherstone, Carol Macdonald, Derek J Hoare
    Abstract:

    Abstract Background Chronic tinnitus is a common incurable condition often associated with depression, anxiety, insomnia and reduced quality of life. Within National Health Service (NHS) audiology in the United Kingdom (UK), no standard protocol currently exists for the treatment of tinnitus. Counselling is only available in less than half of audiology departments, and there is no agreed standard for what constitutes tinnitus counselling. There is substantial evidence from systematic reviews for the clinical benefit of cognitive behaviour therapy (CBT) for tinnitus delivered by clinical psychologists or psychiatrists, but no studies have sufficiently evidenced the NHS model of tinnitus care where management is increasingly being delivered by audiology professionals. In a pilot randomised controlled trial (RCT), this study aims to evaluate the feasibility of comparing a psychologically informed guidance manual developed to support Audiologist management of tinnitus with usual treatment. Methods/design Phase 1 consisted of three development stages: (1) a scoping review to generate a comprehensive set of tinnitus counselling components, (2) a Delphi survey involving expert patients (n = 18) and clinicians (n = 21) to establish consensus on the essential core attributes of tinnitus counselling, and (3) incorporation of these elements into a manualised care protocol. In phase 2, following training in a dedicated workshop, the manualised intervention will be delivered by three experienced Audiologists across three different sites. Patients (n = 30) will be randomly allocated to receive either (1) psychologically informed management from an Audiologist trained to deliver the manualised intervention or (2) treatment as usual (TAU) from an Audiologist who has not received this training. Quantitative outcome measures will be administered at baseline, discharge and 6-month follow-up. Qualitative interviews with participating patients and clinicians will be conducted to gather perspectives on the feasibility and acceptability of the manualised intervention. Discussion The feasibility of proceeding to a definitive RCT will be assessed via compliance with the manual, willingness to be randomised, number of eligible participants, rate of recruitment, retention and collection of quantitative outcome measures. This research offers an important first step to an evidence-based, standardised and accessible approach to tinnitus care. Trial registration ISRCTN13059163 . Date of registration: 6 May 201

  • equity and person centeredness in provision of tinnitus services in uk national health service audiology departments
    European Journal for Person Centered Healthcare, 2015
    Co-Authors: Derek J Hoare, Emily Broomhead, David Stockdale, Veronica Kennedy
    Abstract:

    Rationale, aim and objective: Chronic tinnitus is a prevalent condition broadly managed using individualised sound-based interventions, individualised or group education, counselling, or cognitive therapies. In the UK, therapy is largely delivered by Audiologists or hearing therapists and, where available, clinical psychologists and physicians. Changes in the structure of the health service necessitate ongoing evaluation to monitor equity and person-centeredness of care. The purpose of the current evaluation was to describe provision and explore diversities in the services provided for tinnitus patients across the four countries of the UK and consider these relative to current commissioning and clinical practice guidelines.  Method: A 37 item questionnaire was devised and distributed via email and social media to reach audiology departments in the UK and 147 valid responses were acquired during the 3 month period of the evaluation. Results: The structure and provision of tinnitus services varies widely across the four countries of the United Kingdom in terms of which clinicians provide the services. Outside of England there was no report of clinical psychology or audiovestibular physician involvement in services. There is also variability in access to psychological therapy or support (little training in CBT in Scotland and none in Northern Ireland), self-help groups (little involvement but interest from clinicians) and devices (e.g., one quarter of departments do not currently offer combination hearing aid devices for tinnitus). Clinicians are increasingly using validated questionnaires to evaluate the effectiveness of tinnitus management in their departments. Conclusions: Training in and the provision of psychological support for tinnitus patients by Audiologists is particularly a concern for Scotland and Northern Ireland and has implications for the person-centeredness of audiology services. Capacity and need for research in paediatric tinnitus, combination devices, non-ear level sound devices and Audiologist-delivered psychological therapy, are noted.

Catherine M Mcmahon - One of the best experts on this subject based on the ideXlab platform.

  • postgraduate training in audiology improves clinicians audiology related cue utilisation
    International Journal of Audiology, 2018
    Co-Authors: Jarrah Watkinson, Catherine M Mcmahon, Grant Bristow, Jaime C Auton, Mark W Wiggins
    Abstract:

    AbstractObjective: This study was designed to test whether cue utilisation might be employed as a tool to assess the diagnostic skills of Audiologists. The utilisation of cues is a characteristic of expertise and critical for successful diagnoses in clinical settings. However, neither in training nor in practice, is there a means by which the diagnostic skills of Audiologists can be assessed objectively and reliably.Design: The study comprised a pre-post training evaluation, controlling for prior exposure to the diagnostic testing tool.Study sample: Three cohorts of trainee Audiologists were evaluated, one of which was tested prior to, and following a two-year training programme (16 participants), while the other two groups acted as controls (23 participants and 20 participants, respectively).Results: Consistent with expectations, cue utilisation increased from the initial to the final stages of training and this effect could not be attributed to cohort nor learning effects.Conclusions: At an applied leve...

  • Reliability of the Home Hearing Test: Implications for Public Health.
    Journal of The American Academy of Audiology, 2018
    Co-Authors: Cornetta L Mosley, Lauren M Langley, Adrian Davis, Catherine M Mcmahon, Kelly Tremblay
    Abstract:

    BACKGROUND: The projected increase in the aging population raises concerns about how to manage the health-care needs in a cost-effective way. Within hearing health care, there are presently too few Audiologists to meet the expected demand, and training more professionals may not be a feasible way of addressing this problem. For this reason, there is a need to develop different ways of assessing hearing sensitivity that can be conducted accurately and inexpensively when a certified Audiologist and/or sound-attenuated booth is unavailable. More specifically, there is a need to determine if the Etymotic Home Hearing Test (HHT) can yield accurate and reliable data from older adults with varying degrees of hearing loss. PURPOSE: To compare audiometric thresholds obtained using the HHT, an automated pure-tone air-conduction test, to those obtained using manual audiometry (MA), among older adults with varying degrees of hearing loss. STUDY SAMPLE: Participants were 112 English-speaking adults (58% Female), aged 60 yr and older. Participants were excluded from this study if otoscopy revealed cerumen impaction and/or suspected ear pathology. INTERVENTION: All participants completed the HHT on tablet computers in a carpeted classroom and MA in a double-walled sound-attenuated booth using insert earphones for both measures. Both measures were completed in the same test session, and the order of testing (MA versus HHT) was counterbalanced. DATA COLLECTION AND ANALYSIS: Absolute differences in threshold measurements (in dB HL) were calculated across all ears (n = 224 ears) and for all frequencies (octave frequencies from 0.5 to 8 kHz). Correlation and multiple linear regression analyses were conducted to determine if thresholds obtained using the HHT significantly correlated with thresholds using MA. Mean thresholds for each method (HHT and MA) were compared using correlation analyses for each test frequency. Multiple linear regression analysis was used to examine the relationship between the four-frequency pure-tone average (PTA) (average threshold at 0.5, 1, 2, and 4 kHz) in the better-hearing ear measured using the HHT and a set of seven independent factors: four-frequency PTA in the better-hearing ear measured via MA, treatment group (HHT versus MA), age, gender, and degree of hearing loss (mild, moderate, and >moderate). RESULTS: Correlation analyses revealed significant frequency-specific correlations, ranging from 0.91 to 0.97 (p < 0.001), for air-conduction thresholds obtained using the HHT and MA. Mean HHT thresholds were significantly correlated with mean MA thresholds in both ears across the frequency range. This relationship held true across different degrees of hearing loss. The regression model accounted for a significant amount of variance in the HHT better-ear PTA, with MA better-ear PTA being the only significant predictor in our final model, with no effect of degree of loss, age, or gender. CONCLUSIONS: The HHT is an accurate and cost-effective method of establishing pure-tone air-conduction thresholds, when compared with MA. Therefore, the HHT can be used as a tool to acquire accurate air-conduction hearing thresholds from older adults, in-group settings, without the use of a sound-attenuated booth or a certified Audiologist.

  • decision making in audiology balancing evidence based practice and patient centered care
    Trends in hearing, 2017
    Co-Authors: Isabelle Boisvert, Caitlin Barr, Jennifer Clemesha, Erik Lundmark, Erica Crome, Catherine M Mcmahon
    Abstract:

    Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of information Audiologists use when discussing rehabilitation choices with clients, and discuss the findings within the context of evidence-based practice and patient-centered care. To assess the changes that may have occurred over time, this study uses a questionnaire based on one of the few studies of decision-making behavior in Audiologists, published in 1989. The present questionnaire was completed by 96 Audiologists who attended the World Congress of Audiology in 2014. The responses were analyzed using qualitative and quantitative approaches. Results suggest that Audiologists rank clinical test results and client preferences as the most important factors for decision-making. Discussion with colleagues or experts was also frequently reported as an important source influencing decision-making. Approximately 20% of Audiologists mentioned utilizing research evidence to inform decision-making when no clear solution was available. Information shared at conferences was ranked low in terms of importance and reliability. This study highlights an increase in awareness of concepts associated with evidence-based practice and patient-centered care within audiology settings, consistent with current research-to-practice dissemination pathways. It also highlights that these pathways may not be sufficient for an effective clinical implementation of these practices.

  • improving access to hearing services for people with low vision piloting a hearing screening and education model of intervention
    Ear and Hearing, 2014
    Co-Authors: Julie Schneider, Catherine M Mcmahon, Moira Dunsmore, Bamini Gopinath, Annette Kifley, Paul Mitchell, Stephen R Leeder, Jie Jin Wang
    Abstract:

    OBJECTIVES The aims of this study were to investigate the potential unmet need for hearing services among older people attending low-vision rehabilitation, and pilot a "Hearing Screening and Education Model" (HSEM) of intervention to promote use of hearing services and aids among these individuals. DESIGN In the Vision-Hearing project, 300 clients attending low-vision clinics in Sydney, Australia, participated in baseline interviews and the HSEM (2010-2011). The HSEM consisted of: (1) standard pure-tone audiometry; (2) discussion of hearing loss and implications of dual sensory impairment; and (3) provision of information on hearing services and facilitated referral. Those with hearing loss who did not own hearing aids, reported low use (<1 hr/day), or used a single aid with bilateral loss were referred for full assessment by an Audiologist and to the follow-up arm of the study (n = 210). Follow-up interviews were conducted within 12 months to ascertain actions taken and audiological and other health outcomes. RESULTS Of 169 participants in the follow-up study, 68 (40.2%) sought help for hearing loss within 12 months. Help-seekers had higher mean hearing handicap scores at baseline compared with non-help-seekers. The majority of help-seekers (85.3%) underwent a complete hearing assessment. Fifty-four percent (n = 37) were recommended hearing aids and the majority of these (n = 27) obtained new hearing aids. Seven participants had existing aids adjusted, and 3 obtained alternate assistive listening devices. Almost half of those receiving new aids or adjustments to hearing aids reported low use (<1 hr/day) at follow-up. Among help-seekers, 40% were unsure or did not believe their Audiologist knew of their visual diagnosis. Of concern, 60% of participants did not seek help largely due to perceptions their hearing loss was not bad enough; the presence of competing priorities; concerns over dealing with vision loss and managing hearing aids with poor vision. CONCLUSIONS Hearing- and vision-rehabilitation services need to better screen for, and take account of, dual sensory impairment among their older clients. If Audiologists are made more aware of visual conditions affecting their clients, they may be better placed to facilitate access to appropriate technologies and rehabilitation, which may improve aid retention and benefit.

Dean M Thompson - One of the best experts on this subject based on the ideXlab platform.

  • psychological therapy for people with tinnitus a scoping review of treatment components
    Ear and Hearing, 2017
    Co-Authors: Dean M Thompson, Deborah A Hall, Dawnmarie Walker, Derek J Hoare
    Abstract:

    Background: Tinnitus is associated with depression and anxiety disor- ders, severely and adversely affecting the quality of life and functional health status for some people. With the dearth of clinical psychologists embedded in audiology services and the cessation of training for hearing therapists in the UK, it is left to Audiologists to meet the psychological needs of many patients with tinnitus. However, there is no universally standardized training or manualized intervention specifically for audiolo- gists across the whole UK public healthcare system and similar systems elsewhere across the world. Objectives: The primary aim of this scoping review was to catalog the components of psychological therapies for people with tinnitus, which have been used or tested by psychologists, so that they might inform the development of a standardized Audiologist-delivered psy- chological intervention. Secondary aims of this article were to identify the types of psychological therapy for people with tinnitus, who were reported but not tested in any clinical trial, as well as the job roles of clinicians who delivered psychological therapy for people with tinnitus in the literature. Design: The authors searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL; LILACS; KoreaMed; IndMed; PakMediNet; CAB Abstracts; Web of Science; BIOSIS Previews; ISRCTN; ClinicalTrials.gov; IC-TRP; and Google Scholar. In addition, the authors searched the gray literature including conference abstracts, disserta- tions, and editorials. No records were excluded on the basis of controls used, outcomes reached, timing, setting, or study design (except for reviews—of the search results. Records were included in which a psy- chological therapy intervention was reported to address adults (≤18 years) tinnitus-related distress. No restrictive criteria were placed upon the term tinnitus. Records were excluded in which the intervention included biofeedback, habituation, hypnosis, or relaxation as necessary parts of the treatment. Results: A total of 5043 records were retrieved of which 64 were retained. Twenty-five themes of components that have been included within a psychological therapy were identified, including tinnitus educa- tion, psychoeducation, evaluation treatment rationale, treatment plan- ning, problem-solving behavioral intervention, thought identification, thought challenging, worry time, emotions, social comparison, inter- personal skills, self-concept, lifestyle advice, acceptance and defusion, mindfulness, attention, relaxation, sleep, sound enrichment, comorbid- ity, treatment reflection, relapse prevention, and common therapeutic skills. The most frequently reported psychological therapies were cogni- tive behavioral therapy, tinnitus education, and internet-delivered cogni- tive behavioral therapy. No records reported that an Audiologist delivered any of these psychological therapies in the context of an empirical trial in which their role was clearly delineated from that of other clinicians. Conclusions: Scoping review methodology does not attempt to appraise the quality of evidence or synthesize the included records. Further research should therefore determine the relative importance of these dif- ferent components of psychological therapies from the perspective of the patient and the clinician.

  • A psychologically informed, Audiologist-delivered, manualised intervention for tinnitus: protocol for a randomised controlled feasibility trial (Tin Man study)
    'Springer Science and Business Media LLC', 2017
    Co-Authors: John A. Taylor, Dean M Thompson, Deborah A Hall, Dawnmarie Walker, David Stockdale, Mary Mcmurran, Amanda Casey, Debbie Featherstone, Carol Macdonald, Derek J Hoare
    Abstract:

    Abstract Background Chronic tinnitus is a common incurable condition often associated with depression, anxiety, insomnia and reduced quality of life. Within National Health Service (NHS) audiology in the United Kingdom (UK), no standard protocol currently exists for the treatment of tinnitus. Counselling is only available in less than half of audiology departments, and there is no agreed standard for what constitutes tinnitus counselling. There is substantial evidence from systematic reviews for the clinical benefit of cognitive behaviour therapy (CBT) for tinnitus delivered by clinical psychologists or psychiatrists, but no studies have sufficiently evidenced the NHS model of tinnitus care where management is increasingly being delivered by audiology professionals. In a pilot randomised controlled trial (RCT), this study aims to evaluate the feasibility of comparing a psychologically informed guidance manual developed to support Audiologist management of tinnitus with usual treatment. Methods/design Phase 1 consisted of three development stages: (1) a scoping review to generate a comprehensive set of tinnitus counselling components, (2) a Delphi survey involving expert patients (n = 18) and clinicians (n = 21) to establish consensus on the essential core attributes of tinnitus counselling, and (3) incorporation of these elements into a manualised care protocol. In phase 2, following training in a dedicated workshop, the manualised intervention will be delivered by three experienced Audiologists across three different sites. Patients (n = 30) will be randomly allocated to receive either (1) psychologically informed management from an Audiologist trained to deliver the manualised intervention or (2) treatment as usual (TAU) from an Audiologist who has not received this training. Quantitative outcome measures will be administered at baseline, discharge and 6-month follow-up. Qualitative interviews with participating patients and clinicians will be conducted to gather perspectives on the feasibility and acceptability of the manualised intervention. Discussion The feasibility of proceeding to a definitive RCT will be assessed via compliance with the manual, willingness to be randomised, number of eligible participants, rate of recruitment, retention and collection of quantitative outcome measures. This research offers an important first step to an evidence-based, standardised and accessible approach to tinnitus care. Trial registration ISRCTN13059163 . Date of registration: 6 May 201

Hoare, Derek J. - One of the best experts on this subject based on the ideXlab platform.

  • Patients’ and clinicians’ views of the psychological components of tinnitus treatment that could inform Audiologists’ usual care: A Delphi survey
    'Ovid Technologies (Wolters Kluwer Health)', 2018
    Co-Authors: Thompson, Dean M., Hall, Deborah A., Mcmurran Mary, Casey Amanda, Stockdale David, Featherstone Debbie, Taylor John, Walker, Dawn Marie, Hoare, Derek J.
    Abstract:

    Objectives: The aim of this study was to determine which components of psychological therapies are most important and appropriate to inform Audiologists’ usual care for people with tinnitus. Design: A 39-member panel of patients, Audiologists, hearing therapists, and psychologists completed a three-round Delphi survey to reach consensus on essential components of Audiologist-delivered psychologically informed care for tinnitus. Results: Consensus (≥80% agreement) was reached on including 76 of 160 components. No components reached consensus for exclusion. The components reaching consensus were predominantly common therapeutic skills such as Socratic questioning and active listening, rather than specific techniques, for example, graded exposure therapy or cognitive restructuring. Consensus on educational components to include largely concerned psychological models of tinnitus rather than neurophysiological information. Conclusions: The results of this Delphi survey provide a tool to develop Audiologists’ usual tinnitus care using components that both patients and clinicians agree are important and appropriate to be delivered by an Audiologist for adults with tinnitus-related distress. Research is now necessary to test the added effects of these components when delivered by Audiologists.

  • Patients' and clinicians' views of the psychological components of tinnitus treatment that could inform Audiologists’ usual care: a Delphi survey
    'Ovid Technologies (Wolters Kluwer Health)', 2017
    Co-Authors: Thompson, Dean M., Taylor, John A., Hall, Deborah A., Walker Dawn-marie, Mcmurran Mary, Casey Amanda, Stockdale David, Featherstone Debbie, Hoare, Derek J.
    Abstract:

    Background Tinnitus is a phantom auditory sensation typified by subjective reports of a ringing or buzzing noise, and is associated with reduced quality of life and functional health status. Psychological therapies delivered by psychologists have been found to improve tinnitus-related distress, and although some Audiologists deliver psychological interventions, these are not standardized in the UK. There is a lack of clinical psychologists to provide this care, and the remit of the Audiologist in the UK has expanded to meet this need. This study provides data on the components of psychological therapies from the literature that patients and clinicians consider may usefully inform Audiologists’ usual care for tinnitus. Objectives The aim of this study was to determine which components of psychological therapies are most important and appropriate to inform Audiologists’ usual care for people with tinnitus. Design A 39-member panel of patients, Audiologists, hearing therapists, and psychologists completed a 3-round Delphi survey to reach consensus on essential components of Audiologist-delivered psychologically informed care for tinnitus. Results Consensus (≥ 80% agreement) was reached on including 76 of 160 components. No components reached consensus for exclusion. The components reaching consensus were predominantly common therapeutic skills such as Socratic questioning and active listening, rather than specific techniques, for example, graded exposure therapy or cognitive restructuring. Consensus on educational components to include largely concerned psychological models of tinnitus rather than neurophysiological information. Conclusions The results of this Delphi survey provide a tool to develop Audiologists’ usual tinnitus care using components that both patients and clinicians agree are important and appropriate to be delivered by an Audiologist for adults with tinnitus-related distress. Research is now necessary to test the added effects of these components when delivered by Audiologists

  • A psychologically informed, Audiologist-delivered, manualised intervention for tinnitus: protocol for a randomised controlled feasibility trial (Tin Man study)
    'Springer Science and Business Media LLC', 2017
    Co-Authors: Taylor John, Thompson, Dean M., Hall, Deborah A., Walker Dawn-marie, Mcmurran Mary, Casey Amanda, Stockdale David, Featherstone Debbie, Macdonald Carol, Hoare, Derek J.
    Abstract:

    Background  Chronic tinnitus is a common incurable condition often associated with depression, anxiety, insomnia and reduced quality of life. Within National Health Service (NHS) audiology in the United Kingdom (UK), no standard protocol currently exists for the treatment of tinnitus. Counselling is only available in less than half of audiology departments, and there is no agreed standard for what constitutes tinnitus counselling. There is substantial evidence from systematic reviews for the clinical benefit of cognitive behaviour therapy (CBT) for tinnitus delivered by clinical psychologists or psychiatrists, but no studies have sufficiently evidenced the NHS model of tinnitus care where management is increasingly being delivered by audiology professionals. In a pilot randomised controlled trial (RCT), this study aims to evaluate the feasibility of comparing a psychologically informed guidance manual developed to support Audiologist management of tinnitus with usual treatment.  Methods/design  Phase 1 consisted of three development stages: (1) a scoping review to generate a comprehensive set of tinnitus counselling components, (2) a Delphi survey involving expert patients (n = 18) and clinicians (n = 21) to establish consensus on the essential core attributes of tinnitus counselling, and (3) incorporation of these elements into a manualised care protocol. In phase 2, following training in a dedicated workshop, the manualised intervention will be delivered by three experienced Audiologists across three different sites. Patients (n = 30) will be randomly allocated to receive either (1) psychologically informed management from an Audiologist trained to deliver the manualised intervention or (2) treatment as usual (TAU) from an Audiologist who has not received this training. Quantitative outcome measures will be administered at baseline, discharge and 6-month follow-up. Qualitative interviews with participating patients and clinicians will be conducted to gather perspectives on the feasibility and acceptability of the manualised intervention.  Discussion  The feasibility of proceeding to a definitive RCT will be assessed via compliance with the manual, willingness to be randomised, number of eligible participants, rate of recruitment, retention and collection of quantitative outcome measures. This research offers an important first step to an evidence-based, standardised and accessible approach to tinnitus care

Mcmurran Mary - One of the best experts on this subject based on the ideXlab platform.

  • The TinMan study: feasibility trial of a psychologically informed, Audiologist-delivered, manualised intervention for tinnitus
    'Informa UK Limited', 2020
    Co-Authors: Mcmurran Mary
    Abstract:

    ObjectiveTo develop a manualised psychological treatment for tinnitus that could enhance Audiologist usual care, and to test feasibility of evaluating it in a randomised controlled trial.DesignFeasibility trial, random allocation of patients to manualised treatment or treatment as usual, and mixed-methods evaluation.Study sample: Senior Audiologists, and adults with chronic tinnitus.ResultsRecruitment reached 63% after 6 months (feasibility pre-defined as 65%). Only nine patients (47%) were retained for the duration of the trial. Patients reported that the treatment was acceptable and helped reassure them about their tinnitus. Audiologists reported mixed feelings about the kinds of techniques that are presented to them as ‘psychologically informed’. Audiologists also reported lacking confidence because the training they had was brief, and stated that more formal supervision would have been helpful to check adherence to the treatment manual.ConclusionsThe study indicate potential barriers to Audiologist use of the manual, and that a clinical trial of the intervention is not yet feasible. However, positive indications from outcome measures suggest that further development work would be worthwhile. Refinements to the manual are indicated, and training and supervision arrangements to better support Audiologists to use the intervention in the clinic are required

  • Patients’ and clinicians’ views of the psychological components of tinnitus treatment that could inform Audiologists’ usual care: A Delphi survey
    'Ovid Technologies (Wolters Kluwer Health)', 2018
    Co-Authors: Thompson, Dean M., Hall, Deborah A., Mcmurran Mary, Casey Amanda, Stockdale David, Featherstone Debbie, Taylor John, Walker, Dawn Marie, Hoare, Derek J.
    Abstract:

    Objectives: The aim of this study was to determine which components of psychological therapies are most important and appropriate to inform Audiologists’ usual care for people with tinnitus. Design: A 39-member panel of patients, Audiologists, hearing therapists, and psychologists completed a three-round Delphi survey to reach consensus on essential components of Audiologist-delivered psychologically informed care for tinnitus. Results: Consensus (≥80% agreement) was reached on including 76 of 160 components. No components reached consensus for exclusion. The components reaching consensus were predominantly common therapeutic skills such as Socratic questioning and active listening, rather than specific techniques, for example, graded exposure therapy or cognitive restructuring. Consensus on educational components to include largely concerned psychological models of tinnitus rather than neurophysiological information. Conclusions: The results of this Delphi survey provide a tool to develop Audiologists’ usual tinnitus care using components that both patients and clinicians agree are important and appropriate to be delivered by an Audiologist for adults with tinnitus-related distress. Research is now necessary to test the added effects of these components when delivered by Audiologists.

  • Patients' and clinicians' views of the psychological components of tinnitus treatment that could inform Audiologists’ usual care: a Delphi survey
    'Ovid Technologies (Wolters Kluwer Health)', 2017
    Co-Authors: Thompson, Dean M., Taylor, John A., Hall, Deborah A., Walker Dawn-marie, Mcmurran Mary, Casey Amanda, Stockdale David, Featherstone Debbie, Hoare, Derek J.
    Abstract:

    Background Tinnitus is a phantom auditory sensation typified by subjective reports of a ringing or buzzing noise, and is associated with reduced quality of life and functional health status. Psychological therapies delivered by psychologists have been found to improve tinnitus-related distress, and although some Audiologists deliver psychological interventions, these are not standardized in the UK. There is a lack of clinical psychologists to provide this care, and the remit of the Audiologist in the UK has expanded to meet this need. This study provides data on the components of psychological therapies from the literature that patients and clinicians consider may usefully inform Audiologists’ usual care for tinnitus. Objectives The aim of this study was to determine which components of psychological therapies are most important and appropriate to inform Audiologists’ usual care for people with tinnitus. Design A 39-member panel of patients, Audiologists, hearing therapists, and psychologists completed a 3-round Delphi survey to reach consensus on essential components of Audiologist-delivered psychologically informed care for tinnitus. Results Consensus (≥ 80% agreement) was reached on including 76 of 160 components. No components reached consensus for exclusion. The components reaching consensus were predominantly common therapeutic skills such as Socratic questioning and active listening, rather than specific techniques, for example, graded exposure therapy or cognitive restructuring. Consensus on educational components to include largely concerned psychological models of tinnitus rather than neurophysiological information. Conclusions The results of this Delphi survey provide a tool to develop Audiologists’ usual tinnitus care using components that both patients and clinicians agree are important and appropriate to be delivered by an Audiologist for adults with tinnitus-related distress. Research is now necessary to test the added effects of these components when delivered by Audiologists

  • A psychologically informed, Audiologist-delivered, manualised intervention for tinnitus: protocol for a randomised controlled feasibility trial (Tin Man study)
    'Springer Science and Business Media LLC', 2017
    Co-Authors: Taylor John, Thompson, Dean M., Hall, Deborah A., Walker Dawn-marie, Mcmurran Mary, Casey Amanda, Stockdale David, Featherstone Debbie, Macdonald Carol, Hoare, Derek J.
    Abstract:

    Background  Chronic tinnitus is a common incurable condition often associated with depression, anxiety, insomnia and reduced quality of life. Within National Health Service (NHS) audiology in the United Kingdom (UK), no standard protocol currently exists for the treatment of tinnitus. Counselling is only available in less than half of audiology departments, and there is no agreed standard for what constitutes tinnitus counselling. There is substantial evidence from systematic reviews for the clinical benefit of cognitive behaviour therapy (CBT) for tinnitus delivered by clinical psychologists or psychiatrists, but no studies have sufficiently evidenced the NHS model of tinnitus care where management is increasingly being delivered by audiology professionals. In a pilot randomised controlled trial (RCT), this study aims to evaluate the feasibility of comparing a psychologically informed guidance manual developed to support Audiologist management of tinnitus with usual treatment.  Methods/design  Phase 1 consisted of three development stages: (1) a scoping review to generate a comprehensive set of tinnitus counselling components, (2) a Delphi survey involving expert patients (n = 18) and clinicians (n = 21) to establish consensus on the essential core attributes of tinnitus counselling, and (3) incorporation of these elements into a manualised care protocol. In phase 2, following training in a dedicated workshop, the manualised intervention will be delivered by three experienced Audiologists across three different sites. Patients (n = 30) will be randomly allocated to receive either (1) psychologically informed management from an Audiologist trained to deliver the manualised intervention or (2) treatment as usual (TAU) from an Audiologist who has not received this training. Quantitative outcome measures will be administered at baseline, discharge and 6-month follow-up. Qualitative interviews with participating patients and clinicians will be conducted to gather perspectives on the feasibility and acceptability of the manualised intervention.  Discussion  The feasibility of proceeding to a definitive RCT will be assessed via compliance with the manual, willingness to be randomised, number of eligible participants, rate of recruitment, retention and collection of quantitative outcome measures. This research offers an important first step to an evidence-based, standardised and accessible approach to tinnitus care